Individual
KATHERINE A FLOREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW LCSW
Contact information
Practice address
1640 SOUTH AVE W, MISSOULA, MT 59801-7804
(406) 543-3485
(406) 543-3485
Mailing address
PO BOX 1621, MISSOULA, MT 59806-1621
(406) 550-1004
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
399LCSW
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000502792
—
MT
01
—
71031
BLUE CROSS BLUE SHIELD
MT
Enumeration date
08/18/2006
Last updated
07/08/2007
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